Diabetes: Should I Get an Insulin Pump?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Your options

Key points to remember

An
insulin pump can free you from a strict regimen of
meals, sleep, and exercise, because you can program it to match your changing
schedule.

After you learn how to work with a pump, it
can make living with diabetes easier. But it takes some time and effort to
learn how to use the pump to keep it working properly and to control your
diabetes.

Using a pump includes checking your blood sugar 4 or
more times a day and carefully counting the grams of
carbohydrate that you eat.

If you give
yourself shots 2 times a day or less, having a pump may help you keep your
blood sugar in your target range. If you are already giving yourself shots 3 or
more times a day, a pump may not improve your control, or it may improve your
control only slightly.

Using an insulin pump can keep your blood
sugar at a more constant level so that you don't have as many big swings in
your levels. People who use pumps have fewer problems with very low blood
sugar.

Insulin pumps cost as much as $6,000. Many insurance companies
cover the cost of insulin pumps, but they have strict guidelines that you will
have to follow before they will pay.

An insulin pump constantly
gives you a small amount of insulin, called a "basal rate," throughout the day
and night to help control your blood sugar. When you need extra insulin to
cover a meal or to correct high blood sugar, you tell the pump to give you a
small dose of rapid-acting insulin.

You wear the
insulin pump, which is about the size of a deck of cards, clipped to a belt or
somewhere in your clothing. Plastic tubing connects the pump to a catheter just
under your skin. The catheter is a tiny plastic tube that you insert into your
skin using a special needle. You have to change the catheter every 2 or 3
days.

A pump does not work by
itself. You have to program it. It will not measure your blood sugar, so you
will still have to do that. It will not deliver extra rapid-acting insulin
unless you tell it to. For example, if you figure out that you need an extra 5
units of insulin to cover a meal, you have to punch in that number on the
pump.

You can disconnect the pump from the catheter site for brief
periods when you want to go swimming or take a shower.

With a pump, you can plan your insulin
around your life instead of planning your life around your insulin shots. Your
basal rate is set and runs automatically. If you decide to stay out late, skip
a meal, or work at a job with changing shifts, you can adjust your insulin at
the push of a button.

Instead of giving yourself shots several
times a day, you only need to insert a catheter needle once every 2 or 3
days.

With a pump, you don't have to stop what you're doing and
pull out a syringe or an
insulin pen to give yourself insulin. You just push a
button to give yourself the right dose.

A pump may help you keep
your blood sugar in your target range. People who use a pump have fewer big swings
in their blood sugar levels.

Pumps work well for people who can't find an insulin dose that
keeps blood sugar under control without also causing low blood sugar.

You may have to stay in the hospital, or
spend a whole day at a clinic, while you learn how to use your
pump.

Setting your basal rates for the first time may take a few
days. You may have to skip a few meals and check your sugar levels extra often
while you get used to the pump.

People who keep their sugar levels
in a tight range may be less able to sense when their blood sugar is low. So
you will need to check your blood sugar often, at least 4 times a day, when you
use an insulin pump.

If you are not good at counting your
carbohydrate grams, an insulin pump may not help you control your
diabetes.

Infection at the area where the catheter goes into the
skin is a common problem with insulin pumps. It is one of the most
common reasons why people stop using pumps. So it's
important to take good care of the site and change the catheter on
schedule.

The pump could stop working without your noticing. A pump has
an alarm system to tell you when something is wrong with insulin delivery or if
the pump's battery is getting low. But the alarm system will not tell you if the catheter is bent or has pulled out, so
it's important to check the site often.

Diabetic ketoacidosis (DKA), a life-threatening condition, may happen more often and more
quickly with an insulin pump than with injections.
Your blood sugar could get too high if something goes wrong with the catheter
or pump without your noticing. Most studies show that this is usually not a
problem with training and practice.

Insulin pumps cost as much as $6,000. Many
insurance companies will pay for insulin pumps, but they have strict guidelines
that you will have to follow before they will pay.

Personal stories about insulin pumps

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I got my
insulin pump 3 years ago. I was pretty nervous about how well I'd be able to
program my pump and take care of it. There was so much to learn! But I had a
great team of people helping me, including my doctor, my dietitian, and even
the manufacturer of my pump. Still, I almost gave up after 3 months because I
was attached to the pump constantly. It was always there to remind me that I
had diabetes, you know? But my doctor talked me into sticking with it a little
longer. Now I would not want to go back. Before the pump, diabetes controlled
my life. With the pump, I feel like I am now in control of my diabetes—and my
life.

Sally, age
50

I was on an insulin pump for more than 2
years, and then I quit. I know most people just love their pumps, but I could
not handle being attached to it all the time. For me, the hassle of constantly
taking my blood sugar and figuring out how to program my doses wasn't worth it.
Plus, I got a lot of infections at the catheter site. I went back to injections
and feel happier with my life now.

Abner, age 35

I got my
pump as a teenager, and I love it. But my parents had to work really hard to
get the insurance company to pay for it. We had to keep detailed logs for
months to show them what I ate, what my blood sugar was, and how much insulin I
gave myself every day. I had to prove to them that I was willing and able to
work hard to keep my blood sugar under control. After about 3 months, they
agreed to cover my pump. I'm a police officer now, and having a pump makes it
much easier to do my job.

Jake, age 22

I have several reasons for not wanting an
insulin pump. I'm a pretty private person and I wouldn't want people to notice
that I'm wearing a pump. Also, I play football and basketball almost
year-round, and it's a big part of my life. I know you can safely disconnect
the pump for an hour or so, but my games last longer than that. I just don't
like the idea of being hooked up to a pump 24 hours a day.

Xiang, age 29

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to get an insulin pump

Reasons not to get an insulin pump

I wish I didn't have to give myself insulin shots every day.

I am comfortable giving myself injections.

More important

Equally important

More important

I can live with being constantly attached to a pump.

I don't like the idea of having to stay attached to the pump.

More important

Equally important

More important

I feel ready to take on the responsibilities involved in using an insulin pump.

Using and caring for an insulin pump seems too complicated for me.

More important

Equally important

More important

I want a more flexible lifestyle than my current insulin shot schedule allows.

My schedule is the same every day, so it's not hard to schedule my shots.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Getting an insulin pump

NOT getting an insulin pump

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

How can an insulin pump help me manage diabetes?

It will get rid of my need for insulin.No, that's not right. Your body will always need insulin, no matter how well you control your diabetes. An insulin pump may help you keep your blood sugar in your target range, which is the most important part of managing diabetes.

It can cure my diabetes.No, that's not right. Unfortunately, there is no cure for diabetes. But you can live a long and healthy life by managing your diabetes and keeping your blood sugar in your target range. A pump may help you do that.

I'm not sure.It may help to go back and read "Get the Facts." A pump can help you manage diabetes by helping to keep your blood sugar in your target range.

2.

How hard will it be to learn to use an insulin pump?

It will be very easy.No, that's not right. It would be nice if it were easy, but learning how to use an insulin pump can take some time and effort. Most people find that it's worth it.

An insulin pump can count my carbs for me.No, that's not right. The pump can't count your carbs for you. You'll need to count carbs every time you eat so you can tell the pump what to do at every meal and sometimes in between.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Diabetes: Should I Get an Insulin Pump?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the facts

Your options

Get an insulin pump.

Keep doing
insulin injections.

Key points to remember

An
insulin pump can free you from a strict regimen of
meals, sleep, and exercise, because you can program it to match your changing
schedule.

After you learn how to work with a pump, it
can make living with diabetes easier. But it takes some time and effort to
learn how to use the pump to keep it working properly and to control your
diabetes.

Using a pump includes checking your blood sugar 4 or
more times a day and carefully counting the grams of
carbohydrate that you eat.

If you give
yourself shots 2 times a day or less, having a pump may help you keep your
blood sugar in your target range. If you are already giving yourself shots 3 or
more times a day, a pump may not improve your control, or it may improve your
control only slightly.

Using an insulin pump can keep your blood
sugar at a more constant level so that you don't have as many big swings in
your levels. People who use pumps have fewer problems with very low blood
sugar.

Insulin pumps cost as much as $6,000. Many insurance companies
cover the cost of insulin pumps, but they have strict guidelines that you will
have to follow before they will pay.

FAQs

What is an insulin pump?

An insulin pump constantly
gives you a small amount of insulin, called a "basal rate," throughout the day
and night to help control your blood sugar. When you need extra insulin to
cover a meal or to correct high blood sugar, you tell the pump to give you a
small dose of rapid-acting insulin.

You wear the
insulin pump , which is about the size of a deck of cards, clipped to a belt or
somewhere in your clothing. Plastic tubing connects the pump to a catheter just
under your skin. The catheter is a tiny plastic tube that you insert into your
skin using a special needle. You have to change the catheter every 2 or 3
days.

A pump does not work by
itself. You have to program it. It will not measure your blood sugar, so you
will still have to do that. It will not deliver extra rapid-acting insulin
unless you tell it to. For example, if you figure out that you need an extra 5
units of insulin to cover a meal, you have to punch in that number on the
pump.

You can disconnect the pump from the catheter site for brief
periods when you want to go swimming or take a shower.

What are the benefits of using an insulin pump?

With a pump, you can plan your insulin
around your life instead of planning your life around your insulin shots. Your
basal rate is set and runs automatically. If you decide to stay out late, skip
a meal, or work at a job with changing shifts, you can adjust your insulin at
the push of a button.

Instead of giving yourself shots several
times a day, you only need to insert a catheter needle once every 2 or 3
days.

With a pump, you don't have to stop what you're doing and
pull out a syringe or an
insulin pen to give yourself insulin. You just push a
button to give yourself the right dose.

A pump may help you keep
your blood sugar in your target range. People who use a pump have fewer big swings
in their blood sugar levels.

Pumps work well for people who can't find an insulin dose that
keeps blood sugar under control without also causing low blood sugar.

What are the drawbacks of using an insulin pump?

You may have to stay in the hospital, or
spend a whole day at a clinic, while you learn how to use your
pump.

Setting your basal rates for the first time may take a few
days. You may have to skip a few meals and check your sugar levels extra often
while you get used to the pump.

People who keep their sugar levels
in a tight range may be less able to sense when their blood sugar is low. So
you will need to check your blood sugar often, at least 4 times a day, when you
use an insulin pump.

If you are not good at counting your
carbohydrate grams, an insulin pump may not help you control your
diabetes.

Infection at the area where the catheter goes into the
skin is a common problem with insulin pumps. It is one of the most
common reasons why people stop using pumps. So it's
important to take good care of the site and change the catheter on
schedule.

The pump could stop working without your noticing. A pump has
an alarm system to tell you when something is wrong with insulin delivery or if
the pump's battery is getting low. But the alarm system will not tell you if the catheter is bent or has pulled out, so
it's important to check the site often.

Diabetic ketoacidosis (DKA), a life-threatening condition, may happen more often and more
quickly with an insulin pump than with injections.
Your blood sugar could get too high if something goes wrong with the catheter
or pump without your noticing. Most studies show that this is usually not a
problem with training and practice.

Insulin pumps cost as much as $6,000. Many
insurance companies will pay for insulin pumps, but they have strict guidelines
that you will have to follow before they will pay.

Why might your doctor recommend an insulin pump?

Your doctor might encourage you to get an insulin pump if:

You have big swings in your blood sugar
levels.

You cannot find an insulin dose that keeps your blood sugar
under control without also causing low blood sugar.

Your eating and
activity schedules change a lot, making it hard to schedule insulin
shots.

You don't need more than 100 units of insulin each
day.

2. Compare your options

Using an insulin pump

Not using an insulin
pump

What is usually involved?

Instead of giving yourself
insulin shots every day, you insert a catheter every few days.

The
pump stays attached to you, through the catheter, 24 hours a day.

You test your blood sugar often, and you carefully count carbs so
that you can program the pump.

Infusion sites can get infected, so
it's important to know how to place the catheter correctly and to keep the area
clean.

Daily insulin shots
may work better than a pump for people who need more than 100 units of insulin
a day.

What are the risks and side effects?

Using a pump
may not improve blood-sugar control in people who are already giving themselves
insulin shots 3 or more times a day.

People who keep their sugar
levels in a tight range—which a pump helps you to do—may be less able to sense
when their blood sugar is low.

Infections are common at the
catheter site.

The pump could stop working without your noticing.

Daily
shots may not control your blood sugar as well as a pump
would.

People who use daily shots have more problems with very low
blood sugar.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about insulin pumps

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I got my insulin pump 3 years ago. I was pretty nervous about how well I'd be able to program my pump and take care of it. There was so much to learn! But I had a great team of people helping me, including my doctor, my dietitian, and even the manufacturer of my pump. Still, I almost gave up after 3 months because I was attached to the pump constantly. It was always there to remind me that I had diabetes, you know? But my doctor talked me into sticking with it a little longer. Now I would not want to go back. Before the pump, diabetes controlled my life. With the pump, I feel like I am now in control of my diabetes—and my life."

— Sally, age
50

"I was on an insulin pump for more than 2 years, and then I quit. I know most people just love their pumps, but I could not handle being attached to it all the time. For me, the hassle of constantly taking my blood sugar and figuring out how to program my doses wasn't worth it. Plus, I got a lot of infections at the catheter site. I went back to injections and feel happier with my life now."

— Abner, age 35

"I got my pump as a teenager, and I love it. But my parents had to work really hard to get the insurance company to pay for it. We had to keep detailed logs for months to show them what I ate, what my blood sugar was, and how much insulin I gave myself every day. I had to prove to them that I was willing and able to work hard to keep my blood sugar under control. After about 3 months, they agreed to cover my pump. I'm a police officer now, and having a pump makes it much easier to do my job."

— Jake, age 22

"I have several reasons for not wanting an insulin pump. I'm a pretty private person and I wouldn't want people to notice that I'm wearing a pump. Also, I play football and basketball almost year-round, and it's a big part of my life. I know you can safely disconnect the pump for an hour or so, but my games last longer than that. I just don't like the idea of being hooked up to a pump 24 hours a day."

— Xiang, age 29

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to get an insulin pump

Reasons not to get an insulin pump

I wish I didn't have to give myself insulin shots every day.

I am comfortable giving myself injections.

More important

Equally important

More important

I can live with being constantly attached to a pump.

I don't like the idea of having to stay attached to the pump.

More important

Equally important

More important

I feel ready to take on the responsibilities involved in using an insulin pump.

Using and caring for an insulin pump seems too complicated for me.

More important

Equally important

More important

I want a more flexible lifestyle than my current insulin shot schedule allows.

My schedule is the same every day, so it's not hard to schedule my shots.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Getting an insulin pump

NOT getting an insulin pump

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
How can an insulin pump help me manage diabetes?

It will get rid of my need for insulin.

It can help me keep my blood sugar in my target range.

It can cure my diabetes.

I'm not sure.

You're right. The most important part of managing diabetes is keeping your blood sugar in your target range. A pump may help you do that.

2.
How hard will it be to learn to use an insulin pump?

It will be very easy.

It will take some time and effort.

It will take a lot of training, and it will probably be too hard for me.

I'm not sure.

Correct! Learning how to use and program your insulin pump takes time and effort, but most people find that it's worth it.

3.
How will a pump affect keeping track of my blood sugar?

I won't have to worry about keeping track of my blood sugar anymore.

I will only have to prick my finger once a day to check my blood sugar.

I will have to prick my finger 4 or more times a day to check my blood sugar.

I'm not sure.

That's right. People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. You will need to check your blood sugar often, at least 4 times a day, when you use an insulin pump.

4.
How will a pump affect counting carbohydrate grams?

I will still have to count my carbs every time I eat.

An insulin pump can count my carbs for me.

A pump makes counting my carbs unnecessary.

I'm not sure.

Yes, it's true. You'll need to count your carbs every time you eat so you can tell the pump what to do at every meal and sometimes in between.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

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